Family Income at Birth and Risk of Attention Deficit Hyperactivity Disorder at Age 15: Racial Differences
Family Income at Birth and Risk of Attention Deficit Hyperactivity Disorder at Age 15: Racial Differences
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DOI：
10.3390/children6010010
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发表时间：
2019-01-01
期刊：
影响因子：
2.4
通讯作者：
Caldwell, Cleopatra Howard
中科院分区：
文献类型：
--
作者：
Assari, Shervin;Caldwell, Cleopatra Howard
背景：社会经济地位（SES）资源保护儿童和成人免受医疗和精神疾病的风险。然而，根据少数群体收益减少理论，这种保护作用对少数种族和族裔群体成员的系统性影响比白人弱。目的：我们使用一个全国性的数据集进行了15年的随访，比较了黑人和白色青年出生时家庭经济地位对15岁时注意缺陷多动障碍（ADHD）风险的影响。脆弱家庭和儿童福利研究（FFCWS，1998-2016）是一项针对出生至15岁城市青年的纵向前瞻性研究。该分析包括2006名青年，他们是白色（n = 360）或黑人（n = 1646）。自变量是家庭收入，因变量是15岁时的ADHD。儿童性别、母亲年龄和出生时的家庭类型是协变量，种族是焦点调节因子。我们在整个样本中进行了逻辑回归，并具体到种族。结果：在总体样本中，出生时的高家庭收入与15岁时ADHD的风险无关，独立于所有协变量。尽管存在这种关系，但我们发现种族和出生时家庭收入之间存在显着的相互作用，对随后的ADHD风险有影响，这表明白人比黑人的影响更大。在分层模型中，我们发现家庭SES对白色青年ADHD风险的保护作用略显着。另一方面，对于非裔美国青年，家庭SES被证明有轻微的ADHD风险。结论：黑人家庭的健康收益低于白色家庭，这与少数民族的收益减少一致。健康差距的解决方案不仅仅是旨在减少社会经济地位种族差距的政策，因为美国各种种族健康差距不是由于获得资源的差异，而是这些资源对健康结果的影响。因此，公共政策不应仅限于平等获得资源，还应解决影响黑人生活的结构性种族主义和歧视问题。政策应打击种族主义，并应帮助黑人家庭克服生活中的障碍，使他们能够从社会经济地位和社会流动性中获得健康。由于种族主义是多层次的，需要多层次的干预措施来解决社会经济地位下降的问题。
Background: Socioeconomic status (SES) resources protect children and adults against the risk of medical and psychiatric conditions. According to the Minorities' Diminished Returns theory, however, such protective effects are systemically weaker for the members of racial and ethnic minority groups compared to Whites. Aims: Using a national data set with 15 years of follow up, we compared Black and White youth for the effects of family SES at birth on the risk of Attention Deficit Hyperactivity Disorder (ADHD) at age 15. Methods: The Fragile Families and Child Wellbeing Study (FFCWS, 1998-2016) is a longitudinal prospective study of urban youth from birth to age 15. This analysis included 2006 youth who were either White (n = 360) or Black (n = 1646). The independent variable was family income, the dependent variable was ADHD at age 15. Child gender, maternal age, and family type at birth were covariates, and race was the focal moderator. We ran logistic regressions in the overall sample and specific to race. Results: In the overall sample, high family income at birth was not associated with the risk of ADHD at age 15, independent of all covariates. Despite this relationship, we found a significant interaction between race and family income at birth on subsequent risk of ADHD, indicating a stronger effect for Whites compared to Blacks. In stratified models, we found a marginally significant protective effect of family SES against the risk of ADHD for White youths. For African American youth, on the other hand, family SES was shown to have a marginally significant risk for ADHD. Conclusions: The health gain that follows family income is smaller for Black than White families, which is in line with the Minorities' Diminished Returns. The solution to health disparities is not simply policies that aim to reduce the racial gap in SES, because various racial health disparities in the United States are not due to differential access to resources but rather the impact of these resources on health outcomes. Public policies, therefore, should go beyond equalizing access to resources and also address the structural racism and discrimination that impact Blacks' lives. Policies should fight racism and should help Black families to overcome barriers in their lives so they can gain health from their SES and social mobility. As racism is multi-level, multi-level interventions are needed to tackle diminished returns of SES.